Efficacy of Transoral Fundoplication vs Omeprazole for Treatment of Regurgitation in a Randomized Controlled Trial

Hunter, John G.; Kahrilas, Peter J.; Bell, Reginald; Wilson, Erik B.; Trad, Karim S.; Dolan, James P.; Perry, Kyle A.; Oelschlager, Brant K.; Soper, Nathaniel J.; Snyder, Brad; Burch, Miguel; Melvin, W. Scott; Reavis, Kevin M.; Turgeon, Daniel G.; Hungness, Eric S.; Diggs, Brian S.

doi:10.1053/j.gastro.2014.10.009

Cited by 186 publications

(161 citation statements)

References 21 publications

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“…However, this method is limited to patients who do not have hiatal hernia. In the studies conducted [9,14], the effectiveness of this method was confirmed after 6 months; however, its effects after 1 year were not fully satisfactory and normalisation of the oesophageal pH occurred only in 29% of patients. In relation to the limitation of the reliability of studies concerning the endoscopic methods of treatment of GERD, at present, this type of therapy cannot replace the standard surgical treatment.…”

Section: Discussionmentioning

confidence: 98%

“…The first method, EsophyX, consists of the reconstruction of the gastroesophageal valve. The effectiveness of this method has been confirmed in several studies, compared to pharmacotherapy, or even with Nissen fundoplication, which is considered the gold standard for treatment [8][9][10]. The second procedure by Stretta applies radiofrequency energy in the form of radio waves to the lower oesophageal sphincter and the gastric cardia.…”

Section: Discussionmentioning

confidence: 98%

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Benign diseases of the gastro-oesophageal junction

Nawacki¹,

Głuszek²,

Kuder³

2016

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Introduction: Benign diseases of the gastro-oesophageal junction are among the most frequent gastroenterological diseases, and include hiatal hernia of the diaphragm, gastro-oesophageal reflux, and oesophageal achalasia. The first two entities are frequently concomitant diseases; therefore, sometimes it is difficult to differentiate from which disease dominant symptoms are seen in a patient. Due to their anatomical location the diseases of the gastro-oesophageal junction may imitate complaints on the part of other organs and systems. A patient with sharp stabbing pain in the chest would probably be diagnosed for coronary, and not reflux disease. This is related with delayed diagnosis and implementation of the proper treatment. Aim of the research: To demonstrate our own experiences in surgical management of diseases of the gastro-oesophageal junction, the available methods, and outcomes of treatment. Material and methods:Retrospective analysis was performed of medical records of patients hospitalised in one research centre due to diseases of the gastro-oesophageal junction. The type of disease, age, gender, treatment method, duration of surgical procedure, duration of hospitalisation, and the outcome of treatment were taken into consideration. Results and conclusions:The outcomes of treatment were compiled in the form of a table. It was confirmed that in the case of diseases of the gastro-oesophageal junction, surgical treatment is a very important element, with a low number of complications and very good therapeutic effect.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 98%

Benign diseases of the gastro-oesophageal junction

Nawacki¹,

Głuszek²,

Kuder³

2016

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“…In the first study, RESPECT, patients with regurgitation and daily PPIs were evaluated: either TIF and placebo, or "sham surgery" and PPI (omeprazole). TIF eliminated regurgitation in 67% of patients, and PPI only in 45%, esophageal acid exposure(EAE) improved in patients submitted to TIF, but did not normalize (36). TEMPO RCT compared TIF versus PPIs in patients with regurgitation and atypical symptoms: at 6 months, atypical symptoms were absent in 62% of patients versus 5%.…”

Section: Introductionmentioning

confidence: 99%

New Minimally Invasive Endoscopic and Surgical Therapies for Gastroesophageal Reflux Disease (GERD)

Nicolau¹,

Lobonţiu²,

Constantinoiu³

2018

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RezumatBRGE a devenit cea mai frecventã afecţiune a polului digestiv superior, afecţiune spectralã şi evolutivã cu posibile complicaţii severe. Terapia principalã şi efectivã în majoritatea cazurilor este tratamentul medical (TM) axat pe IPP. Cazurile severe cu alterarea funcţiei sfincterului esofagian inferior (SEI) şi modificãri anatomice importante vor fi abordate chirurgical, fundoplicatura laparoscopicã (FL), intervenţia de elecţie, cu rezultate bune la distanţã, dar cu posibile efecte negative postoperatorii. 30-40 % dintre pacienţi sunt refractãri la TM, dar mulţi nu doresc intervenţia chirurgicalã. Apare un "gol terapeutic", pacienţi cu BRGE care nu beneficiazã de tratament. Pentru pacienţii cu BRGE, selectaţi, fãrã forme severe şi complicaţii şi fãrã modificãri anatomice importante (hernii hiatale mici), în mod special pentru cei refractari la TM, au apãrut noi terapii miniminvazive: mai eficiente ca şi TM, dar mai puţin agresive şi cu efecte secundare minime comparativ cu FL. Sunt terapii endoscopice care amelioreazã funcţia SEI prin terapie termicã, procedeul Stretta® şi rezecţia mucoasei antireflux, respectiv realizarea unei fundoplicaturi parţiale cu ajutorul unor dipozitive de agrafare: EsophyX®, Muse™, Gerd-X™. Tehnicile laparoscopice pot rezolva HH mai mari (peste 2 cm) când se impune, iar în locul fundoplicaturii se poate monta un şirag de mãrgele magnetice la nivelul joncţiunii gastroesofagiene, procedeul LINX®, respectiv electrozi pentru stimulare electricã a SEI, EndoStim®. Aceste procedee s-au dovedit

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“…The patient was observed for 24 hours after the procedure and was discharged in a stable condition. Recent prospective randomized studies have shown the TIF procedure to be effective treatment for a subset of patients with acid reflux [1,2]. However, although TIF appears to be a very promising therapeutic option for patients who refuse to take medications or whose condition is refractory to medical therapy, some patients may not respond.…”

mentioning

confidence: 99%

“…However, although TIF appears to be a very promising therapeutic option for patients who refuse to take medications or whose condition is refractory to medical therapy, some patients may not respond. Up to one-third may have persistent symptoms after 6 months, and up to 11 % have no response at all [2]. Real-time feedback of the morphologic and structural effects of TIF at the gastroesophageal junction and high pressure zone may be helpful in predicting the efficacy of a TIF procedure.…”

mentioning

confidence: 99%

Real-time measurement of luminal compliance during transoral incisionless fundoplication

et al. 2015

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Efficacy of Transoral Fundoplication vs Omeprazole for Treatment of Regurgitation in a Randomized Controlled Trial

Abstract: TF was an effective treatment for patients with GERD symptoms, particularly in those with persistent regurgitation despite PPI therapy, based on evaluation 6 months after the procedure. Clinicaltrials.gov no: NCT01136980.

Cited by 186 publications

References 21 publications

Benign diseases of the gastro-oesophageal junction

Benign diseases of the gastro-oesophageal junction

New Minimally Invasive Endoscopic and Surgical Therapies for Gastroesophageal Reflux Disease (GERD)

Real-time measurement of luminal compliance during transoral incisionless fundoplication

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